Differential removal of human pathogenic viruses from sewage by conventional and ozone treatments

Sewage contains a mixed ecosystem of diverse sets of microorganisms, including human pathogenic viruses. Little is known about how conventional as well as advanced treatments of sewage, such as ozonation, reduce the environmental spread of viruses. Analyses for viruses were therefore conducted for three weeks in influent, after conventional treatment, after additional ozonation, and after passing an open dam system at a full-scale treatment plant in Knivsta, Sweden. Viruses were concentrated by adsorption to a positively charged filter, from which they were eluted and pelleted by ultracentrifugation, with a recovery of about 10%. Ion Torrent sequencing was used to analyze influent, leading to the identification of at least 327 viral species, most of which belonged to 25 families with some having unclear classification. Real-time PCR was used to test for 21 human-related viruses in inlet, conventionally treated, and ozone-treated sewage and outlet waters. The viruses identified in influent and further analyzed were adenovirus, norovirus, sapovirus, parechovirus, hepatitis E virus, astrovirus, pecovirus, picobirnavirus, parvovirus, and gokushovirus. Conventional treatment reduced viral concentrations by one to four log10, with the exception of adenovirus and parvovirus, for which the removal was less efficient. Ozone treatment led to a further reduction by one to two log10, but less for adenovirus. This study showed that the amount of all viruses was reduced by conventional sewage treatment. Further ozonation reduced the amounts of several viruses to undetectable levels, indicating that this is a promising technique for reducing the transmission of many pathogenic human viruses.     

Life expectancy and healthy life expectancy changes between 2000 and 2015: an analysis of 183 World Health Organization member states

Aim

To analyze the changes and inequalities in life expectancy (LE) and healthy life expectancy (HLE) of 183 World Health Organization (WHO) member states between 2000 and 2015, focusing on gender differences.

Subjects and methods

An exploratory study was carried out. The database containing information about male and female LE and HLE at birth and at the age of 60 years old, for the years 2000 and 2015, was gathered for each country from WHO’s global health observatory.

Results

Countries with low LE (respectively HLE) are obtaining greater gains in LE (respectively HLE), overcoming infant mortality, while countries with greater LE (respectively HLE) are improving the elderly’s survivorship. Gains in LE are expected to be followed by gains in HLE, but such gains are getting smaller over time. The female-male LE gap is strongly correlated with the female-male HLE gap. A regression towards the mean is observed regarding the gender gap.

Conclusions

Monitoring of LE and HLE indicators is important to assess the health situation in countries across time, detecting both successful and unsuccessful cases. In our analysis, we noticed that African countries are overcoming the bad results of the 1990s and that army conflicts are the main cause of losses in LE in the third millennium.

     

Impact of untreated dental caries severity on the quality of life of preschool children and their families: a cross-sectional study

Purpose

Untreated dental caries is a persistent oral problem among preschool children. Although there is vast evidence regarding the impact of dental caries on oral health-related quality of life (OHRQoL) in this age group, evidence on the impact of untreated caries severity is scarce. The purpose of this study was to investigate the impact of untreated caries severity on the OHRQoL of preschool children and their families.

Methods

A cross-sectional study was conducted with 563 individuals in the city of Goiania, Brazil. Data were collected through interviews with parents/caregivers and clinical examinations of their children. The OHRQoL was measured by the Brazilian version of the Early Childhood Oral Health Impact Scale. Untreated dental caries severity was assessed using validated indices. Other independent variables were socioeconomic, toothache prevalence, and the questionnaire respondent. Statistical analysis involved bivariate comparisons and Poisson regression analyses.

Results

A higher prevalence of impact on OHRQoL was found among preschool children with untreated dental caries with clinical consequences (PR 1.31; 95% CI 1.01–1.70) compared to those without caries; those aged 5 years (PR 1.47; 95% CI 1.18–1.82), compared to those aged two; and those with a toothache (PR 1.54; 95% CI 1.34–1.76), compared to those without toothache. Moreover, fathers (PR 0.71; 95% CI 0.55–0.92) and other respondents (PR 0.70; 95% CI 0.52–0.96) perceived less impact on the OHRQoL in comparison to mothers.

Conclusions

Severe untreated dental caries with clinical consequences had a negative impact on the children’s OHRQoL, regardless of toothache and socioeconomic factors.

     

Rate of deficit accumulation in home care users with intellectual and developmental disabilities

Purpose

To identify factors associated with the rate of deficit accumulation in a population of adults with intellectual and developmental disabilities (IDD).

Will biomarker-based diagnosis of Alzheimer’s disease maximize scientific progress? Evaluating proposed diagnostic criteria

A recently published framework for the diagnosis of Alzheimer’s disease (AD) in research studies would allow diagnosis on the sole basis of two biomarkers (β-amyloid and pathologic tau), even in people with no objective or subjective memory or cognitive changes. This revision will have substantial implications for future Alzheimer’s research, and the changes should be rigorously evaluated before widespread adoption. We propose three principles for evaluating any revision to diagnostic frameworks for AD: (1) does the revision improve the validity of the diagnosis; (2) does the revision improve the reliability or reduce the expense of the diagnosis; and (3) will the revision foster innovative and rigorous research across populations. The new diagnostic framework is unlikely to achieve any of these goals. Instead, it has the potential to handicap future researchers, and slow progress towards identifying effective strategies to prevent or treat AD.     

Implementation of human biomonitoring in the Dehcho region of the Northwest Territories,Canada (2016–2017)

Background

Human biomonitoring represents an important tool for health risk assessment, supporting the characterization of contaminant exposure and nutrient status. In communities where country foods (locally harvested foods: land animals, fish, birds, plants) are integrated in the daily diet, as is the case in remote northern regions where food security is a challenge, such foods can potentially be a significant route of contaminant exposure. To assess this issue, a biomonitoring project was implemented among Dene/Métis communities of the Dehcho region of the Northwest Territories, Canada.

Methods

Participants completed dietary surveys (i.e., a food frequency questionnaire and 24-h recall) to estimate food consumption patterns as well as a Health Messages Survey to evaluate the awareness and perception of contaminants and consumption notices. Biological sampling of hair, urine and blood was conducted. Toxic metals (e.g., mercury, lead, cadmium), essential metals (e.g., copper, nickel, zinc), fatty acids, and persistent organic pollutants (POPs) were measured in samples.

Results

The levels of contaminants in blood, hair and urine for the majority of participants were below the available guidance values for mercury, cadmium, lead and uranium. However, from the 279 participants, approximately 2% were invited to provide follow up samples, mainly for elevated mercury level. Also, at the population level, blood lead (GM: 11 μg/L) and blood cadmium (GM: 0.53 μg/L) were slightly above the Canadian Health Measures Survey data. Therefore, although country foods occasionally contain elevated levels of particular contaminants, human exposures to these metals remained similar to those seen in the Canadian general population. In addition, dietary data showed the importance and diversity of country foods across participating communities, with the consumption of an average of 5.1% of total calories from wild-harvested country foods.

Conclusion

This project completed in the Mackenzie Valley of the Northwest Territories fills a data gap across other biomonitoring studies in Canada as it integrates community results, will support stakeholders in the development of public health strategies, and will inform environmental health issue prioritization.

     

Cost-Effectiveness Analysis of a Navigation Program for Colorectal Cancer Screening to Reduce Social Health Inequalities: A French Cluster Randomized Controlled Trial

Background

Patient navigation programs to increase colorectal cancer (CRC) screening adherence have become widespread in recent years, especially among deprived populations.

Role of a qnr-like gene in the intrinsic resistance of Enterococcus faecalis to fluoroquinolones

Fluoroquinolones are poorly active against enterococci. Recently, plasmid-borne resistance to fluoroquinolones due to the qnr gene was reported in members of the Enterobacteriaceae family. The gene encodes a pentapeptide repeat protein that protects DNA gyrase from inhibition by fluoroquinolones. We have identified in the genome of Enterococcus faecalis V583 a qnr-like gene, named E. faecalis qnr (qnr(E. faecalis)), encoding a putative pentapeptide repeat protein that shares 25% identity with Qnr. To assess its potential role in the intrinsic resistance of E. faecalis to fluoroquinolones, qnr(E. faecalis) was inactivated in E. faecalis JH2-2 by insertion of the thermosensitive vector pG1KT. This strain was then complemented with qnr(E. faecalis) cloned in the multicopy plasmid pORI23. The effects of its overexpression were also studied. Inactivation of the qnr(E. faecalis) gene resulted in twofold decreases in the MICs of ofloxacin and ciprofloxacin. When the gene was complemented or overexpressed, MICs of fluoroquinolones increased four- to nine-fold, leading to MICs of ofloxacin and ciprofloxacin equal to 32 mug/ml and 8 mug/ml, respectively. The E. faecalis Qnr (Qnr(E. faecalis)) protein was produced and purified. Qnr(E. faecalis) protein protected Escherichia coli DNA gyrase from inhibition by ofloxacin. The qnr(E. faecalis) gene was then introduced into E. coli DH10B, Staphylococcus aureus RN4220, and Lactococcus lactis IL-1419 to study its heterologous expression. MICs of the various fluoroquinolones tested increased 4- to 16-fold, showing that Qnr(E. faecalis) conferred resistance to fluoroquinolones in various bacterial backgrounds. Overexpression of qnr(E. faecalis) in enterococci or mobilization of the gene to other bacterial species may be anticipated as a possible new mechanism for fluoroquinolone resistance.